The Hospital for Sick Children's 13th Annual Paediatric Emergency Medicine Conference offers an engaging exchange of knowledge, ideas and innovations with expert faculty and evidence-based clinical applications to direct your practice. I think what makes our conference different is the level of engagement with faculty, the small group learning environment and hands-on practice of critical skills. This year, we are delighted to have three superb keynote speakers:

Dr. Damian Roland from University of Leicester in the UK, an international award winning speaker and innovator in use of social media and educational technology in the ED.

Dr. Allan de Caen from University of Alberta, Stollery Children's Hospital, an expert in management of critically ill children and a key contributor to the revised 2015 AHA guidelines for paediatric resuscitation.

Dr. Deborah Schonfeld from University of Toronto, SickKids leading in early recognition and management of sepsis in the ED.

We are also offering two hands-on pre-conference workshops: the inaugural Advanced Procedural and Resuscitation Skills in PEM, a competency-based workshop offering an opportunity to practice critical skills in paediatric emergency medicine in a simulated environment. As point-of-care ultrasound becomes more integral to emergency medicine, you can enhance your skills by participating in the Paediatric Ultrasound Workshop, which offers both beginner and intermediate training of specific paediatric ultrasound applications.

Whether you’re a seasoned veteran or a brand new attendee, ACEP16 will be an experience like none other. You will find new ways to learn, new opportunities to network, and new reasons to build a solid foundation for our specialty. But there is one thing you can count on being the same – the best emergency medicine education in the world.

Mark your calendars... the WINFOCUS World Congress will be held in Slovenia September 7-10, 2016. It's going to be a really amazing Congress. And, the local physicians are using this as an opportunity to build Emergency Medicine and Pediatric Emergency Medicine as specialties.

The Paediatric Academic Societies (PAS) Annual Meeting is the largest international meeting focused on research in child health. We bring together a variety of groups to not only discuss original research, which has been the hallmark of the PAS meeting, but to also discuss how this research can be applied to actual clinical practice in paediatrics.

All PEM POCUS enthusiasts are welcome! This is an opportunity for us to share ideas in research, education and administration, and to advance and promote the practice of POCUS in PEM through collaboration and mentoring. This past year our network has grown in number of members and institutions, and our ties have strengthened. Join us this year as we continue towards our ultimate goal of the ubiquitous presence of POCUS in paediatric emergency departments. www.p2network.com

The American Institute of Ultrasound in Medicine is a multidisciplinary medical association of more than 9000 physicians, sonographers, scientists, students, and other health care providers. Established more than 50 years ago, the AIUM is dedicated to advancing the safe and effective use of ultrasound in medicine through professional and public education, research, development of guidelines, and accreditation.

Please note, date and time for this event are in Australian Eastern Standard Time (AEST)

This is an invitation to

a Paediatric Emergency Point-of-care Ultrasound ANZ Network,

the PEM POCUS Leads Meetup in Brisbane on November 27 2015 (approximately 10-4)

a PEM POCUS monthly journal club/image review on the fourth Thursday of the month at 10 am AEST commencing in one month (October 22- linkup details to follow)

Our Mission

To support and further develop practice, training and research in point-of-care ultrasound within Paediatric Emergency Medicine in Australia and New ZealandCo-chairs (interim) Robyn Brady (CCPU) LCCH Brisbane and Adam O'Brien (DDU forthcoming) RCH Melbourne

The purposes of the November meet-up include:

to share with other PEM POCUS leads and EM POCUS fore-runners on a wide range of topics including but not limited to:

political and funding battles,

credentialing, audit and governance

ultrasound integrated simulations, phantoms and manikins,

training methodology (sonographers, internal/external workshops etc)

emerging ANZ POCUS research

and further discussion around the creation and shared supervision of a PEM CCPU module for ASUM.

Tanya Carleton, ASUM Education Manager, will be present to support/advise us on the 27th, and representatives from Sonosite and the Australian Institute of Ultrasound have also expressed an interest in attending/supporting. We are also inviting PEM Fellows and sonographers with a particular interest in point-of-care ultrasound to contribute and attend on the 27th.

We welcome ideas of other ways this group could support PEM POCUS development in Australasia, and look forward to connecting with you through 4th Thursdays and online.

What does the author mean when he states, "POCUS has the potential to aid in difficult diagnostic scenarios by contributing an additional piece of the clinical puzzle at the bedside to confirm a high pretest probability diagnosis and to expedite the appropriate patient care”?

Is the author being too cautious? Should this technique be used clinically?

Whether you’re a seasoned veteran or a brand new attendee, ACEP15 will be an experience like none other. You will find new ways to learn, new opportunities to network, and new reasons to build a solid foundation for our specialty. But there is one thing you can count on being the same – the best emergency medicine education in the world.

Monday

Advanced Bedside Echocardiography Lab

MO-6; MO-35 / 3 Hour

Faculty: J. Christian Fox, MD, RDMS, FACEP (Moderator)

Monday, 10/26/2015 / 8:00 AM - 10:50 AM; 12:30 PM - 3:20 PM

Focused cardiac ultrasound is an essential diagnostic test that emergency physicians should be comfortable performing at the bedside. This lab is designed for emergency physicians with a strong fundamental proficiency with EM bedside ultrasound who would like to improve their echocardiography skills. (This lab is limited to 30 participants.)

Critical Care Emergency Ultrasound

MO-22 / 1 Hour

Faculty: Cliff A. Rice, MD

Monday, 10/26/2015 / 12:30 PM - 1:20 PM

The practicing emergency physician needs to be able to utilize ultrasound effectively in the evaluation of the critically ill patient. The speaker will highlight the use of ultrasound to perform an EFAST scan, to dynamically monitor and measure the IVC in the setting of hypovolemic shock, and to detect pericardial effusion and perform ultrasound guided pericardiocentesis. (This course is a prerequisite to the “Critical Care Emergency Ultrasound Lab.”)

Musculoskeletal Ultrasound Scanning Lab

This ultrasound lab will provide an introduction to common emergency department upper and lower extremity musculoskeletal pathologies that can be readily identified with bedside ultrasound. The participant will perform focused ultrasound examinations of the shoulder, hand, knee, hip, ankle and foot. This hands-on lab will provide the training in: foreign body identification, fracture & tendon injury evaluation, joint effusion and abscess identification. This lab will provide the experience participants need to easily integrate these skills into clinical practice. (Course limited to 25 participants)

Procedural Ultrasound

MO-13 / 1 Hour

Faculty: Arun Nagdev, MD

Monday, 10/26/2015 / 11:30 AM - 12:20 PM; 8:00 AM – 9:50 AM; 12:30

The use of ultrasound by emergency physicians to help perform procedures is becoming more frequent. Some of these may soon be considered standard of care and some are useful in selected situations. The speaker will discuss procedural applications for ultrasound that the emergency physician can easily incorporate into daily clinical practice. (This course is a prerequisite to the “Procedural Ultrasound Lab.”)

Saving the Child with Jelly on the Belly!

MO-59 / 1 Hour

Faculty: Russ Horowitz, MD, RDMS

Monday, 10/26/2015 / 3:30 PM - 4:20 PM

Both emergency ultrasound and pediatric emergency ultrasound are rapidly expanding! Multiple easy to learn applications now provide a quick look into the baby’s belly for the busy emergency physician. In this case based interactive review, the speaker will review the evidence behind pediatric emergency abdominal ultrasound applications including pyloric stenosis, intussusception and appendicitis. Additionally, the speaker will provide practical protocols, pearls and pitfalls, needed to put the probe on your pediatric patient pronto!

Venous US in the ED: DVT Skills Lab

During this hands-on lab, participants will practice vascular access and identify the deep venous system in the legs. Compression-decompression ultrasonography will also be performed on healthy models. (This lab is limited to 30 participants.)

Tuesday

Bedside Echocardiography: When Seconds Count

TU-118 / 1 Hour

Faculty: J. Christian Fox, MD, RDMS, FACEP

Tuesday, 10/27/2015 / 10:00 AM - 10:50 AM

The bene­ ts of quick-look echocardiography during resuscitations are numerous and life-saving. Do you start fluids or vasopressors, defibrillate, continue chest compressions, or withhold care? All are options that would be facilitated by this important radiologic procedure. The speaker will present the most recent evidence supporting the use of bedside echocardiography during cardiac resuscitation, emphasizing the ability to distinguish between PEA with and without mechanical activity, and rapid assessment of cardiac output.

Critical Care Emergency Ultrasound Lab

The practicing emergency physician needs to be able to utilize ultrasound effectively in the evaluation of the critically ill patient. This hands-on practical lab will highlight the use of ultrasound to perform a EFAST scan, to dynamically monitor and measure the IVC in the setting of hypovolemic shock, and to detect pericardial effusion and perform ultrasound-guided pericardiocentesis. (Prior attendance in “Critical Care Emergency Ultrasound” is required. This lab is limited to 30 participants.)

Go With the Flow! Adding Doppler to Your Ultrasound Skill Set

TU-184 / 1 Hour

Faculty: David C. Pigott, MD, RDMS, FACEP

Tuesday, 10/27/2015 / 4:30 PM - 5:30 PM

Using Doppler in the ED can take your practice to the next level. The speaker will introduce participants to the various Doppler modes including color Doppler, power Doppler and spectral Doppler. Indications, limitations, and pearls will be highlighted. The course will also review the uses of Doppler ultrasound in the assessment of valvular function & diastolic heart failure, as well as biliary, gynecologic and testicular conditions. The speaker will incorporate case presentations where bedside ultrasound using Doppler imaging resulted in significant changes in clinical management or emergent interventions.

Wednesday

Advanced Pediatric Ultrasound Lab: Kids are Not Just Small Adults… Or Are They?

General emergency medicine providers care for the majority of children in the United States in community hospitals. Point-of-care ultrasound has become the standard of care for adult emergency patients, but is only beginning to emerge in the care of pediatric patients. This lab will provide a hands-on experience that will provide the participants with an excellent foundation to perform pediatric ultrasound in their clinical practice.

Pelvic Ultrasound in the ED: Make the Diagnosis!

WE-282 / 1 Hour

Faculty: David C. Pigott, MD, RDMS, FACEP

Wednesday, 10/28/2015 / 3:30 PM - 4:20 PM

Bedside pelvic ultrasound has been shown to expedite patient care, reduce ED length of stay and improve patient satisfaction. This course will provide an introduction to pelvic ultrasound in the setting of first-trimester pregnancy as well as in the non-pregnant patient. The course will also review the basic techniques for performing transvaginal ultrasound, including the basics of probe orientation, pelvic anatomy and common pitfalls. The course will incorporate case presentations where bedside pelvic ultrasound resulted in significant changes in clinical management or emergent interventions in both pregnant and non-pregnant patients.

Procedural Ultrasound Lab

The use of ultrasound by emergency physicians to help perform procedures is becoming more frequent. Some of these may soon be considered standard of care and some are useful in selected situations. This procedural lab will provide hands-on experience with practical EM ultrasound applications. (Prior attendance in “Procedural Ultrasound” is required. This lab is limited to 30 participants.)

Point-of-Care Ultrasound (POCUS) in EM is now a necessary component of our everyday practice, and its implications stretch far beyond knowing whether a FAST is positive. Using real case scenarios, learners will understand how to incorporate ultrasound into the workup of common patient complaints to confirm or change a presumed diagnosis, broaden differential diagnoses, streamline patient workup, and provide safer more effective care for patients in the ED. The learner will learn the technique for each study performed for each case with pearls on how to obtain optimal imaging quality.

Ten Fatal Imaging Myths That Should Change Your Practice

TH-310 / 1 Hour

Faculty: Andrew D. Perron, MD, FACEP

Thursday, 10/29/2015 / 8:00 AM - 8:50 AM

Diagnostic imaging is critical to many emergency department patients, but myths and misconceptions can result in potentially fatal misdiagnosis or delay. Does a chest x-ray really rule out free air, obstruction, or aortic dissection? Can a normal ovarian ultrasound rule out ovarian torsion? Using a case-based approach with audience participation, the speaker debunks these urban legends, teaching axioms, and myths. By the end of the lecture, you will be armed with the tools to change your practice and be better able to avoid these radiology pitfalls!

The American Academy of Pediatrics (AAP) invites you to take part in a monumental experience October 24–27 in Washington, DC. Experience over 350 educational sessions including practical hands-on learning and networking in addition to the largest pediatric technical exhibit of its kind.

We invite you to join us at the 11th WINFOCUS World Congress on Ultrasound in Emergency and Critical Care Conference that will be held in Boston, MA on October 22 - 25, 2015. World Interactive Network Focused On Critical Ultrasound (WINFOCUS) is the world’s leading scientific organization committed to developing point of care ultrasound practice, research, education, technology, and addressing the needs of patients, institutions, services, and communities in“critical” scenarios.

— http://www.winfocus2015.com/

Our doctors will be teaching and lecturing at WINFOCUS. Be sure to drop in. See the full list of presentations here.

This year we are offering a variety of learning formats to meet your individual learning needs. From short quick hit lectures highlighting new and innovative practices to case-based breakouts and hands-on workshops, all our sessions are designed to bring you evidence-based practical information that you can apply in your own practice setting.

We are delighted to have three superb keynote speakers; Dr James Holmes from UC Davis Children’s Hospital in California, Dr. Garth Meckler from Vancouver Children’s Hospital in British Columbia and our very own Dr. Suzanne Beno from SickKids in Toronto.

We are also offering three hands-on preconference courses including the all new Advanced Paediatric Procedural Sedation Course highlighting key issues and best practices with hi-fidelity simulation cases to practice skills. In addition, as ultrasound becomes a key component of emergency medicine practice, we have added new hands-on beginner ultrasound course to address this need in the paediatric emergency setting. We will also be offering the intermediate level ultrasound course for those who are interested in increasing their paediatric ultrasound skills.

Finally our conference offers an engaging community with faculty who are always ready to answer your questions and international colleagues to develop networks.

Novice and Intermediate sessions

Maximum 24 participants each session

Location: Peter Gilgan Centre for Research and Learning

This innovative one day course offers novice and intermediate point-of-care ultrasound users the unique opportunity to learn PEM-specific applications from leading experts in the field. A novel case-based curriculum will provide practical, hands-on instruction designed to enhance patient care and maximize workflow in your ED.

Novice

Novice attendees will be introduced to knobology, soft tissue and PEM-specific applications such as soft tissue, skull, ocular, lung and hydration status.

After an extremely successful first meeting, we are getting together again! - Anesthesiologists, Emergency Physicians, Intensivists, Internists, and Pediatricians who apply point-of-care ultrasound in the diagnosis and treatment of patients in the acute care setting. This meeting uses a case-based format to facilitate multidisciplinary discussions on the utility of ultrasound in acute care medicine and offers attendees unique exposure to new techniques and applications used by colleagues in other specialties. Plus, we get to share cool cases and amazing images! Join us for a great evening of interdisciplinary discussion and collaboration. All are welcome!

"All were penetrating thoracic injuries with a pericardial effusion on FAST and all were emergently brought to the operating room for a planned sternotomy and were ,therefore, excluded from the study." How do you think this affected the primary outcome?

The authors conclude that identification of pericardial fluid can prevent unnecessary thoracotomies, saving resources and potential risks to the practitioners.

What is the actual resource burden and risk to the practitioner

Can you think of any benefits to performing thoracotamies despite the low survival rate of the patient?

What is the "cylinder tangent effect" as it pertains to ultrasound? Discuss how the visual axis approach and the infraorbital approach differ in their ability to ensure the cylinder of the optic nerve is in plane with the ultrasound beam.

In this healthy volunteer study, the infraorbital approach produced measurements in agreement with the visual axis approach. Do you think this would also be true in patients with increased ONSD?

What issues could arise in EM clinical practice regarding the head and eye positioning described for the infraorbital approach?

What problem could exist in using the infraorbital technique serially (eg to assess response to therapy, or worsening ICP from baseline)?

"The use of point-of-care ultrasound by intensive care clinicians continues to increase, and studies demonstrating improvements in patient outcomes are of great importance," said Daniel Mitchell, DO, lead study author. "In this study, decreased morbidity and calculated cost savings were very promising."